Analysis on status and influencing factors of resistance to antiviral therapy in HIV-1 patients in Tai'an city,Shandong province from 2003 to 2020
Objective To analyze the situation of HIV-1 patients who have received antiviral treatment in Tai'an city,Shandong province from 2003 to 2020,and understand the prevalence of drug resistance and its influence factors,so as to provide support for improving the antiviral treatment of AIDS.Methods The monitoring data of all HIV-infected/AIDS patients who received free antiviral therapy in Tai'an city from 2003 to 2020 were downloaded from the epidemic database of AIDS Prevention and Control Basic Information System of China Disease Prevention and Control Information System.The data included basic treatment information,treatment follow-up forms,and infectious disease report cards.Demographic characteristics,CD4+T cell count,viral load,antiviral drugs,treatment duration,medication compli-ance,and RNA mutation sites of drug-resistant patients were selected.x2 test was used to analyze the gender,age,marital status,education level,infection route,initial CD4+T cell count,treatment duration,initial treatment plan,missed medica-tion,and other factors of the study subjects.The drug resistance mutation sites of antiviral therapy patients and the sensi-tivity of antiviral drugs were statistically analyzed.Multivariate logistic regression analysis was conducted to analyze the influencing factors of drug resistance.Results Among the 688 antiviral therapy patients,31 cases showed varying de-grees of drug resistance,with an overall drug resistance rate of 4.51％.The highest proportion of drug resistance to non-nucleoside reverse transcriptase inhibitors(NNRTIs)was 67.74％(21/31),and no drug resistance to protease inhibitors(PIs)was found.The highest mutation rate site was M184V/I,with a mutation rate of 88.24％(15/17).Analysis of demographic characteristics and baseline follow-up forms of drug-resistant patients showed that different initial CD4+T cell counts(x2=12.286,P=0.002),treatment duration(x2=8.902,P=0.011),initial treatment plan(x2=12.451,P=0.009),and missed medication(x2=29.714,P＜0.001)had statistically significant differences in drug resistance rates among patients.Multivariate logistic regression a-nalysis showed that the initial CD4+T cell count was a protective factor for drug resistance(OR=0.462,95％CI:0.352-0.606,P＜0.05),while treatment duration(OR=1.929,95％CI=1.238-3.005,P＜0.05)and missed medica-tion(OR=3.387,95％CI=1.889-6.074,P＜0.05)were risk factors for drug resistance.Conclusion The overall drug resistance rate of HIV-1 antiviral therapy patients in Tai'an city is relatively low.The highest proportion of drug re-sistance is observed with NNRTIs and the highest mutation rate site is M184V/I.The baseline CD4+T cell count,treat-ment plan,and compliance of patients have impacts on drug resistance.
NETL
NSTL
万方数据
